By Sr Teresa Hayward (RN, RM, Lactation consultant, Infant & Paediatric Nutritionist, Baby Sleep Consultant)
Cot Death, or Sudden Infant Death Syndrome (SIDS), is a scary term to all parents worldwide. It is something that parents truly hope never happens to their family. I have unfortunately in practice, seen a number of Cot Deaths, and it is devastating every time.
SIDS is an unexplained and sudden death of a seemingly healthy baby and usually occurs in babies under 1yr. These deaths typically happen when a baby is sleeping and are often referred to a “cot death”. They do not necessarily occur at night, and most of the ones I have seen have been during the day.
For many years, researchers have been trying to identify the cause and risk factors for SIDS so as to prevent these deaths from occurring. There is new research available that actually states there may be a defect on babies brain that reduces a babies ability to wake or respond to their environment causing vulnerability to SIDS (for more information www.kalb.com/2022/05/12/groundbreaking-new-study-finds-possible-explanation-sids/ )
Although they haven’t found the exact cause of SIDS, there is enough research that indicates SIDS deaths may be related to a combination of risk factors, and that there are protective factors that parents can keep in mind.
Risk Factors for SIDS
As I stated above, some researchers have noted that SIDS may be related to a defect on a portion of the baby’s brain that is related to breathing and arousing them from sleep. Other risk factors include:
· Prematurity – prior to 37wks
· Low birth weight – below 2.5kg at birth
· Being exposed to cigarette smoke during pregnancy and after birth
· Respiratory infections
Brain defects
Being a male
Non-white babies
Being born to moms under the age of 20wks
Use of drugs and alcohol during Pregnancy
Poor or no antenatal care during pregnancy
Overheating from excessive blankets and clothing
Stomach sleeping
Having SIDS deaths with the family
Certain environmental risk facts which have led to the development of Safe sleep guidelines
Protective Factors for SIDS
Safe Sleep Guidelines have been put into place to ensure that babies are sleeping in a safe sleeping environment to lower the risk of SIDS and other types of crib deaths such as suffocation or strangulation.
Placing babies to sleep on their backs in their co-sleeper, cot, bassinet etc, not on their sides or stomach. If they are sleeping on their tummy or their side, their rib cage compresses, preventing their lungs from inflating to their full capacity. This then causes breathing to become laboured and stop. A baby that is on their tummy is also more likely to aspirate if they vomit than a baby on their back. A healthy term baby will turn their head if they vomit and it will not go back into the throat.
Breastfeeding your babies.
Offering a dummy – Using a dummy also helps to reduce cot death. A dummy helps air to enter the baby’s airways but it also helps to strengthen the nerves that control the upper airway. It therefore stimulates your baby to breathe while they are sucking the dummy.
Avoid exposure to harmful toxins such as cigarette smoke, drugs, alcohol fumes. Ensure that your home is a totally smoke free zone. Don’t allow anyone to smoke around your baby, or handle or baby straight after smoking.
Having babies sleep on a firm flat surface, like a cot mattress – never a pillow or cushion. The mattress preferably a breathable one with no pillow, not even a small flat baby pillow. Pillows occlude their airways. If a baby needs to be elevated due to reflux, then it important that they are elevated from their lower back and not just their head is elevated. Also place baby at the bottom of the cot or crib, this prevents them from slipping under any blankets.
Do not use electric blankets or hot water bottles and keep cot away from heaters and direct sunlight.
Take your baby for their regular well baby checkups and keep up to date with their vaccinations and seek medical advice if baby is unwell.
Their cot or sleep space is free of loose items like blankets, stuffed animals, crib bumpers, or other potentially dangerous products ensure no plastic bags, cords clothing are left close to baby
Make sure babies are sleeping in a cool environment and are not at risk of overheating the environment temperature should never be higher than 18 degrees Celsius. While they are sleeping, ensure that their heads are not covered by hoods or hats. Also ensure that they don’t have too many blankets on them and ensure they are not swaddled in fleecy blankets. A baby that is too warm, will go into a deeper sleep and may forget to breathe. Signs that your baby may be overheating are sweating, damp hair, heat rash, rapid breathing, restlessness and fever.
Babies room-share with parents until at least six months old (and even up to 1 year) while avoiding bed-sharing co-sleeping is fine as long as baby is not between parents. If you are co-sleeping, please follow the guidelines below
Tips for safe co sleeping
Parents choose to co-sleep for lots of different reasons but its important to practice safe co-sleeping
Keep pillows and adult bedding away from baby
Make sure baby won’t fall out of bed or get trapped between mattress and wall
Keep pets away from bed and don’t have other children sharing the bed
Follow all the other safe sleep advise to reduce risk of SIDS such as baby sleeping on back
You should not share a bed if
You or your partner have recently drunk alcohol
You or your partner smoke
You have taken any medication that may make you sleepy or less aware
Your baby was born prematurely or very small - before 37wks or weighs less than 2.5kg
While there are many things that we can do to ensure that our babies are sleeping in a safe environment and offer as many protective factors as possible, unfortunately SIDS remains the most a significant cause of infant deaths.
As a parent, it’s important to follow the Safe Sleep Guidelines set out by to minimize your child’s risk of SIDS while taking precautions as best as possible. Ensure that all caregivers are also aware of the guidelines and your wish for them to follow them. This includes creches and nannies. If parents keep up to date with the guidelines, the SIDS risk factors, education, and protective factors, parents can help ensure they are equipped with the knowledge to best support their families. If you feel unsure of guidelines and ways to minimize your child’s risk, reach out to a trusted professional, such as a pediatrician or your clinic sister to discuss further.
SIDS is a frightening cause of death for infants worldwide, and unfortunately, it has impacted many families. As a Baby Sleep Consultant, this new research is hopeful to share with families! While it’s important for families to remain cautious by following Safe Sleep Guidelines, this new study offers hope that there will be a way to identify infants at risk of SIDS. And with future research, there may be the potential to provide preventative support to families.
If at anytime you are concerned, or would like more information on Sleep safety. Please feel free to contact me at 0824009501
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